Intended for healthcare professionals


Using patient experience within pay for performance programmes

BMJ 2009; 339 doi: (Published 20 October 2009) Cite this as: BMJ 2009;339:b4224
  1. Chris Salisbury, professor of primary health care
  1. 1Academic Unit of Primary Health Care, University of Bristol, Bristol BS8 2AA
  1. c.salisbury{at}

    Patient surveys are important but have limitations as a measure of system performance

    “Pay for performance” schemes are being introduced in several countries to incentivise improvements in the quality of health care. In the United Kingdom, the pay of general practitioners is partly based on their performance under the quality and outcomes framework,1 which includes indicators of the process and outcome of care and a limited number of measures of patients’ reported experiences of care. It is important that schemes to improve the quality of health care take account of patients’ priorities and experiences. In the linked study (doi:10.1136/bmj.b3851), Roland and colleagues assess response rates and non-response bias in a national survey of patient experience.2

    Since 2007, national postal surveys have been conducted to assess patients’ views of NHS general practice. In 2009 a more extensive survey was conducted, which included questions on a range of topics known to be important to patients.3 The results of just two questions were linked to payment; both were related to access—the ability to get an urgent appointment and to book an appointment in advance. The …

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